One of the key issues which the NHS faces is whether elderly patients should be admitted to hospital at all, due to the high risk of COVID infection as well as the risk of falls and de-conditioning.
The major responsibility of looking after the healthcare needs of older patients and their families is taken on by Primary Care professionals and Care Homes. They face huge challenges in doing so, in the current pandemic and alongside the fast-approaching winter pressures. This has accelerated the use of innovative approaches, to support elderly patients and other vulnerable patients in need.
One proven approach is the use of Consultant Connect for rapid specialist Elderly Care Advice & Guidance. Our data shows that 63% of calls to Elderly Care Advice & Guidance lines result in an avoided hospital visit. Ultimately, this could even be a lifesaver for some older patients.
Let’s now look at some patient case studies…
- Dr Andrew Russell, A&E consultant at University Hospital Monklands, NHS Lanarkshire, shares his experience:
An elderly female patient in a nursing home had a fall, which resulted in a scalp wound. The wound had been managed by a staff nurse on site with steristrips but the wound needed further treatment. The nurse had phoned NHS 111 and been directed to the Flow Navigation Hub and told to wait for a call via Patient Connect. Dr Andrew Russell, an A&E consultant at University Hospital Monklands then phoned the nurse to discuss via Patient Connect. The patient would have required ambulance transfer both to and from hospital, so Dr Russell phoned the out-of-hours hub to get the number for the area district nurse.
- A GP, who wishes to remain anonymous shares her experience:
The GP had a visit from an elderly male patient who had experienced an anaphylactic reaction to the Cholera vaccine when he was young and was told to avoid any vaccines in future. He had not had any vaccinations since then but was quite keen to have the COVID-19 vaccine. However, he was very concerned and anxious, wishing to get advice from the immunologists and have allergy tests, if needed. The GP used the Consultant Connect App to contact a local immunologist from the local hospital and was able to feedback the reply to the patient the same day. The patient felt reassured and was grateful for a quick answer from the expert to his concerns. He was then able to have his COVID-19 vaccine in the same week.
- Dr Anne Mullin, a GP Glasgow, shares her experience:
An 88-year-old patient was “found to be profoundly hyponatraemic (causing bradycardia and dizziness).” He had “recently undergone tests to investigate retinal artery occlusion.” Urea and Electrolyte results came back late from the lab. Using Consultant Connect’s Telephone Advice & Guidance service, Dr Mullin was able to immediately contact a consultant at Queen Elizabeth University Hospital to discuss the follow up options.
The patient was “seen at the Department for Medicine for the Elderly the following day where appropriate investigations were performed, and his medication was reviewed.” Dr Mullin says that “this avoided a late evening admission as [she] could discuss the patient’s current functional status with the consultant planning the follow up (which was very prompt).” As a result of using Phone Advice & Guidance, an “unnecessary admission” was avoided.
- Consultant Geriatrician in Sunderland, Dr Catherine Barnes explains why she likes answering Telephone Advice & Guidance calls:
The Recovery at Home Team were concerned about an elderly patient, living on her own at home. She was known to have Chronic obstructive pulmonary disease but had recently become more breathless. The patient complained of weight loss and a poor appetite and explained she had been collapsing at home. She had recently been seen in the Emergency Department, but they felt that she wasn’t improving.
“We arranged an urgent Outpatient Clinic appointment, which she attended. We were able to assess her, with access to her medical records and previous investigations. Blood tests, an ECG and lying and standing Blood Pressure were checked and advice with regards to changes to her medication was given. We were able to liaise with other services involved in her care. This enabled the patient to get the assessment and support she needed without an emergency admission.”
More case studies where rapid Advice & Guidance benefitted elderly patients:
- Consultant and GP deliver integrated care for vulnerable, elderly patient
- GP avoids admission for elderly patient
- Consultant and GP provide effective cardiology care for elderly patient
- GP receives rapid haematology A&G, resulting in referral avoided for elderly patient
To discuss how Enhanced Advice & Guidance might work for GPs and other clinicians dealing with the frail elderly in your area, please call us on 01865 261467 or email us at firstname.lastname@example.org.